Handing Over: Developing Consistency Across Shifts in Residential and Health Settings by Barry Mason In the Systemic Thinking and Practice Series edited by D. Campbell and R. Draper London:  Karnac Books, 1991;  81 pp.

We do not change when we are on ‘auto-pilot,’ we only change when difference is introduced in a way which makes us less certain of the position we hold.

While reading this review, if the reader has the experience of finding my thoughts dry or run-of-the-mill, and then unexpectedly interesting for the very fact of their common sense and, dare I say, clarity, then I will have successfully “handed over” the text. Handing Over prescribes a new way of communicating information about patients in residential and healthcare settings at those critical junctures when staff groups pass the baton. Mason (whose clinical training is in family therapy) argues that those taking on a new shift need to be active rather than passive in learning about the goings-on during the previous shift. He finds that the departing staff are depleted by the end of their work period and tend, therefore (to use psychoanalytic language, which this book does not do), to evacuate into the oncoming crew useless factual minutia and unprocessed countertransference reactions to acting out and anxious patients. Mason argues that actively inquiring — not only about the goings-on during the past shift but also about the subjective experience of the team members — disables blaming attitudes, gradually reinstates an attitude of inquiry, and develops more diverse ways of interpreting interactions with patients.

Mason's “systemic handover” has been used in various treatment venues in the UK. However, it appears that there may be only one site in the U.S. where the system is employed — a mental health program in Portland,